The Time Is Right for a Prescription for Exercise

Black doctors’ group turns focus to prevention

The stats are distressing. More than 75 percent of us are overweight or obese, and though we know regular physical activity comes with a whole host of health benefits, with the exception of Latinos, we are more likely to lead sedentary lifestyles than other any other racial or ethnic group. One study of more than 30,000 healthy adult women in this country found middle-aged women need at least an hour of moderate activity every day to maintain a healthy weight without restricting calories, but few of us meet the minimum 30-minutes three times a week recommendation, so it should come as no surprise that daily hour-long workouts aren’t happening.

On top of the obesity and exercise news, there’s the fact that black folks have the highest rates of high blood pressure in the world, and we are more likely to suffer the complications of diabetes, itself an out-of-control epidemic. Both of these conditions can be better managed with physical activity.

It is with all of this in mind that the National Medical Association (NMA) is set to launch its “A Prescription for Exercise” initiative, designed to educate its physician members about the importance of prescribing exercise—alongside pharmaceutical and nutritional protocols—in treatment plans for their patients. Last week, Black Health Matters spoke with NMA President Edith Mitchell and Martin Hamlette, executive director of the NMA, about the program.

Black Health Matters: Why this initiative? Why now?

Edith Mitchell, M.D.: The equation for health involves multiple factors, and it’s important for us to look at the preventive aspect as well as treatment and follow-up. It is trying to prevent complications of disease as opposed to waiting for complications to occur and then treat the disease.

Martin Hamlette: The correlation between wellness and health are now linked. And medicine and access to medicine is an integral part of the overall picture. That includes understanding diet and the importance of exercise. Practitioners serving this community have to incorporate this piece into how they treat a patient.

How are physicians responding to the program?

Dr. Mitchell: Physicians will do those things for which educational programs have demonstrated effectiveness. The problem with many physician practices is that there is no time to do a lot of preventive medicine. So we have to package the educational programs in a manner easily utilizable in the doctor’s office. Other staff members can be complementary. And we’ve got to learn to use the community and churches, with fraternities and sororities and community organizations in our efforts.

How will physicians present this prescription for exercise to their patients?

Dr. Mitchell: Inflammation contributes to the development of heart disease and worsening of the disease for people who already have it. The same is true for rheumatoid arthritis as well as cancer. Exercise decreases inflammation in the body. We have to teach patients why exercise works, just as we’ve been doing colon cancer screening and education for patients for many years.

Hamlette: Primarily this is a physician education campaign. It’s getting down to the details of how you address this topic. It’s increasing patient awareness of how well diet and exercise fit in. It’s not enough for patients to hear that they’re pre-diabetic and need to increase their exercise. What does that mean? Many times patients aren’t in a position where they feel like they can have a dialogue. It’s physicians saying, “It doesn’t have to be joining a gym; it can be taking a flight of stairs” or whatever it might be. The provider now has a new method, and the patient gets the bonus of taking care of their health as well.

What challenges, if any, do you foresee?

Dr. Mitchell: I’m a big proponent of the current health markets making sure those patients who need insurance get the best insurance for their families. But increasing the number of people with insurance is only one aspect of the program. We have to work with CMS to provide better reimbursements to physicians for preventive screenings. Colon cancer screenings? Now covered. Lung cancer patients at high risk—now covered. Breast cancer screening has been covered for some time. Though more insurances are starting to include exercise as part of preventive health, as educators we have to advocate so it can be incorporated into routine office practice.

Hamlette: The success of the program is going to be the number of the physicians we reach, but also how many patients.